Toxic shock syndrome

About toxic shock syndrome

Toxic shock syndrome is caused by harmful substances called toxins released by Staphylococcus aureus or Streptococcus bacteria. Toxic shock syndrome affects about 40 people each year in the UK. It can affect men, women and children. About half of all people who get toxic shock syndrome are women who regularly use tampons.

Symptoms of toxic shock syndrome

The symptoms of toxic shock syndrome tend to come on suddenly and include:

  • a high temperature
  • flu-like symptoms
  • vomiting
  • diarrhoea
  • chills
  • red rash (like sunburn)
  • excessive tiredness
  • aching muscles
  • confusion
  • feeling light-headed or dizzy

If you have these symptoms, see your GP.

Toxic shock syndrome is often associated with tampon use in women. If you think you may have toxic shock syndrome and you’re wearing a tampon, you should remove it as soon as you can and go to hospital straight away.

Complications of toxic shock syndrome

Toxic shock syndrome is a life-threatening condition and needs to be treated urgently. It can cause your blood pressure to drop and your body to go into 'shock', which means there may not be enough blood getting to your organs. This can cause your kidneys, liver and lungs to not work properly.

Causes of toxic shock syndrome

Toxic shock syndrome is caused by toxins released by S. aureus and Streptococci bacteria. These bacteria can be found on the skin of up to four in 10 healthy people and aren’t usually harmful.

It’s not known why some people develop toxic shock syndrome and others don’t, but it’s likely to be caused by a lack of protective antibodies against the S.aureus bacteria. The bacteria can release toxins from any part of your body but it’s most dangerous if the bacteria gets into your bloodstream, for example through a wound.

You’re most at risk of having toxic shock syndrome, if you have:

  • a wound to your skin, for example after an operation
  • diabetes

Women are most at risk of getting toxic shock syndrome:

  • during menstruation – particularly if you're using tampons
  • after childbirth
  • when using an internal barrier contraceptive (such as a diaphragm)

Diagnosis of toxic shock syndrome

Your GP will ask about your symptoms and examine you. He or she may also ask you about your medical history.

If your GP thinks you have toxic shock syndrome, you will be sent to hospital for treatment.

It’s important to tell your GP and your doctor at the hospital about any recent injuries (such as an accident or burn) and if you use tampons or an internal barrier contraceptive. This can help your GP or doctor identify how you got the infection.

Your doctor or nurse may take blood samples. He or she may also take a swab (similar to a small round cotton bud) from a wound, if you have any. This will be sent to a laboratory for testing. 

Treatment of toxic shock syndrome

Toxic shock syndrome is a serious and potentially life-threatening condition. You will need to go to hospital for treatment so you can be closely monitored.

Your doctor will examine, clean and drain any infections you may have, such as surgical wounds or burns. If you're wearing a tampon or an internal contraceptive device, it will be removed immediately.

You will have antibiotics and fluids through a drip to treat the infection and shock.

You may be given oxygen through a mask. If any of your organs are affected, for example, your lungs or kidneys, you may need to be looked after in intensive care.

You may also be given medicines to help increase your blood pressure and an injection of immunoglobulin (a protein that helps fight infection).

Prevention of toxic shock syndrome

There is no clear way to prevent the infection. The key advice is to look out for the symptoms and seek medical treatment straight away if you think you have toxic shock syndrome.
It's not exactly understood why using a tampon is linked with toxic shock syndrome, but tampon absorbency (the amount of menstrual blood a tampon absorbs) is thought to be a factor.
If you're a woman using tampons:

  • use a tampon with the lowest absorbency suitable for your menstrual blood flow
  • change your tampon frequently – washing your hands before and after you insert it
  • use a sanitary towel or panty liner from time to time during your period
  • never insert more than one tampon at one time
  • use a sanitary towel at night instead of a tampon

Once you have had toxic shock syndrome, you can get it again. Women who have had toxic shock syndrome are advised not to wear a tampon or use an internal barrier contraceptive, such as a diaphragm or cap.

Can I get toxic shock syndrome if I have been through the menopause?


Yes, you can still get toxic shock syndrome after the menopause.


Toxic shock syndrome can affect men, women and children of any age. You're more at risk if you have HIV/AIDS or diabetes.

It's important to look out for signs and symptoms of toxic shock syndrome if you have recently had a skin infection or a viral illness, especially chickenpox.

If you think that you have toxic shock syndrome, visit your GP or a hospital immediately.

Is toxic shock syndrome contagious?


No, toxic shock syndrome isn't contagious and can't be passed from person to person.


Toxic shock syndrome develops when your body is suddenly overcome by toxins from bacteria that usually lives harmlessly on your skin and in your body. The bacteria usually enters your bloodstream through open wounds, when you're using a tampon or contraceptive device, or when your immune system isn't strong (for example when you have been ill).

Can people die from toxic shock syndrome?


Yes, up to three in 10 people develop serious complications and may die from toxic shock syndrome.


Toxic shock syndrome occurs when bacteria gets into your bloodstream. The symptoms come on suddenly and the infection can cause your blood pressure to fall dangerously low. Without urgent medical attention your body can go into shock and vital organs, such as your kidneys, lungs and liver, can stop working properly. The sooner toxic shock syndrome is diagnosed and treated, the greater your chance is of making a full recovery.